WASHINGTON-While critics may correctly predict that Al Gore's Medicare prescription drug plan will quickly and inevitably lead to price controls and rationing, thus strangling medical innovation, competing plans announced last week by George W. Bush and the Senate Republican leadership could be the equivalent of death by a thousand cuts.

Bush and Sen. William Roth (R-Del.) are offering to throw billions of dollars to state governments to immediately address the needs of lower income senior citizens. The main difference between them is that Roth, as chairman of the Finance Committee, is acutely aware of the difficulty of paying for the program and offers less money to the states. He also does not echo Bush's commitment to cap out-of-pocket drug costs at $6,000 per year (see BioCentury Extra, Tuesday Sept. 5 & Thursday